Provider Demographics
NPI:1578954939
Name:JONES, TANESHA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TANESHA
Middle Name:
Last Name:JONES
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:TANESHA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:15 POND ST
Mailing Address - Street 2:
Mailing Address - City:UNIONVILLE
Mailing Address - State:CT
Mailing Address - Zip Code:06085-1521
Mailing Address - Country:US
Mailing Address - Phone:860-922-0561
Mailing Address - Fax:
Practice Address - Street 1:1789 NEW BRITAIN AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-3317
Practice Address - Country:US
Practice Address - Phone:860-922-0561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-06
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0098661041C0700X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT009866OtherDEPARTMENT OF PUBLIC HEALTH